Provider Demographics
NPI:1366032682
Name:RESTIEAUX-LOUIS, DANIELLE (MSW, ASW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:RESTIEAUX-LOUIS
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 MENDOCINO AVE # A
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2274
Mailing Address - Country:US
Mailing Address - Phone:707-284-1978
Mailing Address - Fax:
Practice Address - Street 1:3434 MENDOCINO AVE # A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2274
Practice Address - Country:US
Practice Address - Phone:707-284-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW712161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical